Curative effectinvess analysis of ^125I seed implantation and drug for pain caused by metastatic or recurrent head and neck cancers

Abstract

Objective To investigate the curative effectiveness of radioactive ^125Ⅰ-seed implantation and drug treatment in patients with pain caused by recurrent or metastatic head and neck cancers. Methods The retrospective analysis was done on 20 patients, concluding 9 recurrent eases after radiotherapy, 9 cases after radiotherapy and operation, and 2 cases after operation, with pain caused by recurrent or metastatic head and neck cancers from Jan. 2011 to Oct. 2012. They were randomly divided into seed group and support group. The patients in seed group were implanted with ^125Ⅰ seeds guided by CT and ultrasound. The single seed activity ranged from 0. 3-0. 8 mCi （ 1.30 × 10^7-2.96 × 10^7 Bq）. The implantation was carried out according to treatment planning system （TPS）. The patients in support group were treated by drug for support treatment following three steps analgesic therapy from WHO. The pain remission rate, tumor control probability and complications were observed at regular intervals. Results The follow-up time was 6 months. The CR ＋ PR in seed group was 50% , 60% and 80% after 1,2 and 3 months respectively, and that in support group was 0 after 1, 2 and 3 months. The median pain score of two groups was basically stable in 2-4, but the score in support group fluctuated more seriously than seed group. In addition, seed group had lighter complications. Conclusion For the treatment of pain caused by recurrent or metastatic head and neck cancers, interstitial implantation of 125^Ⅰ seeds has more reliable effect in relieving pain, less complication and faster onset of action. Key words: Head and neck cancers; Pain; Brachytherapy; Lodine-125 seed